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Posts from July, 2013

Affordable Care Act Increases the Need for Nurse Recruitment

Written by LeAnn Thieman, CSP, July 30th, 2013

During Nurses Week, Kathleen Sebelius, secretary of the Department of Health and Human Services, called nurses the “healthcare providers at the heart of our healthcare system.”

Sebelius said, “The Affordable Care Act and the expansion of access to healthcare that it offers will not be possible without these trusted professionals. The healthcare law’s emphasis on keeping people healthy, preventing illness and managing chronic conditions opens new opportunities for nurses to shape and lead the future delivery of healthcare and capitalizes on the expertise of the nursing profession.”

As an example, Sebelius cited $1.5 billion in appropriations to increase home visits from nurses and social workers to expectant mothers in high-risk communities. “Nurses making home visits can sharply reduce infant mortality and improve outcomes for mothers and children alike,” she said.

Through the Affordable Care Act, the number of training and educational opportunities for nursing students and graduates to acquire the skills necessary to enter the health workforce is expanding, Sebelius said.

Through several advanced nursing education initiatives (http://bhpr.hrsa.gov/nursing/grants/ane.html), for example, an additional 2,800 nurse practitioners and nurse midwives will enter the primary care workforce over the next five years.

To learn strategies for nurse retention, nurse recruitment, bringing self care to your facility and how to increase work life balance for nurses and healthcare professionals, go to SelfCare for HealthCare. CONTACT ME DIRECTLY to talk about customizing this powerful program for your employees.

Nurse Retention News: Lower Nursing Turnover Helps Ensure High-Quality Care

Written by LeAnn Thieman, CSP, July 25th, 2013

Lower nursing turnover, increasing nurse retention and better practice environments can help rural hospitals ensure high-quality care for heart failure patients, according to a study funded by the Robert Wood Johnson Foundation Interdisciplinary Nursing Quality Research Initiative.

As reported in the May issue of the journal Medical Care, rural hospitals with lower nurse turnover are more likely to implement all four measures that are central to optimal care for heart failure patients:

1) providing counseling on smoking cessation,
2) providing adequate instructions to patients at discharge,
3) assessing left ventricular ejection fraction and
4) ensuring the patient receives angiotensin-converting enzyme inhibitors at discharge.

The researchers tested a quality collaborative intervention in 23 rural hospitals in the eastern United States. The intervention included in-person meetings, an evidence-based toolkit and monthly group teleconference calls between the site coordinators and the team conducting the study. One group of hospitals used the intervention for six months while the other did not. After six months the second group also began using the intervention.

The researchers found no significant difference in implementation of the four core measures as a result of the intervention, but hospitals with lower nurse turnover and better practice environments implemented more of the measures. Better practice environments, as measured by survey responses, specifically were associated with better assessment of left ventricular ejection fraction.

“The results of this study really speak to the central role nurses play in almost any quality improvement effort,” Robin Newhouse, RN, PhD, NEA-BC, FAAN, a co-leader of the study and chair and professor of Organizational Systems and Adult Health at the University of Maryland School of Nursing, said in a news release. “Appropriate practice environments and keeping turnover low are important factors in hospitals’ ability to implement quality initiatives and adopt best practices.”

To learn how to reduce the turnover rate for your nurses, strategies for nurse retention and nurse recruitment and how to increase work life balance for nurses and healthcare professionals, go to SelfCare for HealthCare. CONTACT ME DIRECTLY to talk about customizing this powerful program for your employees.

Nurses Voted Most Honest and Ethical of All Professionals

Written by LeAnn Thieman, CSP, July 23rd, 2013

Nurse Retention: Positive Workplace Attitudes Help Employees Reach Goals

Written by LeAnn Thieman, CSP, July 18th, 2013

One key to workplace success is a positive attitude. When there is a culture of positivity nurse retention and nurse recruitment flourish.

In a recent study, researchers found that positive attitudes helped employees reach workplace goals with peers and especially with superiors.

Elena Wong, PhD, from the Institute of Work and Organizational Psychology at the Université de Neuchâtel in Switzerland, led a research project that studied how expressing positivity in the workplace could help workers reach certain goals.

The emotions a person expresses can be contagious to the other workers. Positive mood can prompt others to be helpful and supportive resulting in high-quality teamwork.

Researchers watched 113 employees between the ages of 18 and 66 in different types of work environments. Each participant was asked to keep a seven-day work diary and to record every social interaction at work that lasted for 10 minutes or longer. For each interaction, they were to record positive and/or negative emotions, such as interest, joy, pride, anger, disappointment and shame. The intensity of each emotion was also to be recorded on a scale from one to five, answering the following question after each interaction: “Have you attained your objective(s) in this interaction?”

The researchers studied a total of 494 workplace interactions. The results showed that expressing positive emotions helped employees to reach goals when interacting with a colleague, when compared to expressing a negative emotion.
The difference between interactions when a superior was present or absent was noted as well. When a superior was present, showing positive emotions doubled the chances of an employee reaching a goal, compared to when only peers were present.

This study was published in May in Frontiers in Emotional Science. While the information isn’t new to most of us, it does make my mental balance tool of positive thinking evidence based!

To learn more of my physical, mental and spiritual life balance tools, strategies for nurse retention, nurse recruitment, bringing self care to your facility and how to increase work life balance for nurses and healthcare professionals, go to SelfCare for HealthCare. CONTACT ME DIRECTLY to talk about customizing this powerful program for your employees.

Nurse Retention News: Meditation and Stretching Can Reduce PTSD in Nurses

Written by LeAnn Thieman, CSP, July 16th, 2013

Practicing meditation and stretching can help relieve symptoms of post-traumatic stress disorder and normalize stress hormone levels, according to a study of nurses. Using these powerful techniques can help increase nurse retention by taking better care of the psychological needs of nurses.

More than 7 million adults nationwide are diagnosed with PTSD in a typical year, according to background information for the study, which is scheduled for publication in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism.

PTSD patients have high levels of corticotrophin-releasing hormone and unusually low levels of cortisol, both of which regulate the body’s response to stress. Although levels of cortisol typically rise in response to stress, PTSD patients have abnormally low levels of cortisol and do better when these levels increase. The study found cortisol levels increased in subjects who participated in mind-body exercises for an eight week-period.

“Mind-body exercise offers a low-cost approach that could be used as a complement to traditional psychotherapy or drug treatments,” the study’s lead author, Sang H. Kim, PhD, of the National Institutes of Health, said in a news release. “These self-directed practices give PTSD patients control over their own treatment and have few side effects.”

The randomized controlled clinical trial studied the impact of mind-body practices in nurses, a group the authors noted is at high-risk of developing PTSD due to repeated exposure to extreme stressors. A study cohort of 28 nurses from the University of New Mexico Hospital, including 22 experiencing PTSD symptoms, was divided into two groups. One group took 60-minute mindfulness sessions twice a week in which participants performed stretching, balancing and deep breathing exercises while focusing on awareness of their body’s movements, sensations and surroundings.

The predominantly female participants underwent blood tests to measure their stress hormone levels and completed the government’s PTSD checklist for civilians. Among those who were enrolled in the mind-body course, cortisol levels in the blood rose 67% and PTSD checklist scores decreased by 41%, indicating the individuals were displaying fewer PTSD symptoms. In comparison, the control group had a nearly 4% decline in checklist scores and a 17% increase in blood cortisol levels during the same period.

“Participants in the mind-body intervention reported that not only did the mind-body exercises reduce the impact of stress on their daily lives, but they also slept better, felt calmer and were motivated to resume hobbies and other enjoyable activities they had dropped,” Kim said. “This is a promising PTSD intervention worthy of further study to determine its long-term effects.”

The article — “PTSD Symptom Reduction with Mindfulness-Based Stretching and Deep Breathing Exercise: Randomized Controlled Clinical Trial of Efficacy” — will appear in the July issue of JCEM.

To learn more about how to cope with and reduce stress for nurses, strategies for nurse retention, nurse recruitment, bringing self care to your facility and how to increase work life balance for nurses and healthcare professionals, go to SelfCare for HealthCare. CONTACT ME DIRECTLY to talk about customizing this powerful program for your employees.

Can Creative Arts Reduce Nurse Burnout and Increase Nurse Retention?

Written by LeAnn Thieman, CSP, July 11th, 2013

When the pediatric oncology unit at the Georgetown Lombardi Comprehensive Cancer Center grieved after the death of a child, an art therapist brought clay. There was a lot of pounding and kneading as they made pots and creations, then they started to talk.

Finding ways to help nurses relax, reflect, and re-energize is critical in helping them prevent or overcome burnout, according to researchers and nurse managers.

“Nurses are particularly at risk for becoming overwhelmed and depleted,” says Cynda Hylton Rushton, a professor in the School of Nursing at Johns Hopkins University. They “provide direct, 24/7 care, and they often must confront the limits of what medicine can do for people. Nurses can begin to feel helpless.”

Preventing burnout is an essential aspect of promoting quality patient care. “When the clinician suffers, so does the patient,” Rushton says. “We don’t provide the quality care we want to offer when we ourselves are depleted.”

The arts and humanities program at Georgetown’s cancer center also uses journal writing, dance and movement, quilting and painting to help. Nancy Morgan, the program’s director, holds journal-writing sessions to allow people “to say something about their experiences, to solve problems, to come to terms with what they’ve experienced.”

She said that when dancers first appeared at an intensive care unit to lead staffers in a brief stretching exercise, it raised some eyebrows. “But people have come to see that it’s not just for fun, but because it can make you a better nurse or doctor.” All of these strategies double as excellent nurse retention tools.

Helping nurses prevent or cope with stress and grief reduces burnout, resulting in happier, healthier nurses…and patients.

To learn more about nurse retention, nurse recruitment, bringing self care to your facility and how to increase work life balance for nurses and healthcare professionals, go to SelfCare for HealthCare. CONTACT ME DIRECTLY to talk about customizing this powerful program for your employees.

Nurse Retention: Stop Verbal Abuse…Retain Nurses

Written by LeAnn Thieman, CSP, July 9th, 2013

Nurses who are verbally abused by colleagues report lower job satisfaction, unfavorable perceptions of their work environment and greater plans to leave their jobs. To stay on top of nurse retention this is something healthcare executives must address.

Researchers with the RN Work Project, a program of the Robert Wood Johnson Foundation, surveyed 1,407 newly licensed RNs about how often they were verbally abused by nurse colleagues: never; one to five times in the last three months (moderate); or more than five times in the last three months (high).

49% of respondents had experienced some verbal abuse, but thankfully only 5% had experienced abuse more than five times in the past three months. Being spoken to in a condescending manner and being ignored were the most frequently reported types of abuse.

Day shift nurses experienced higher levels of verbal abuse than those working evenings and weekends. RNs working eight-hour shifts were less likely to experience abuse than those working 12-hour shifts. Staffing shortfalls also were correlated with higher levels of abuse.

Intent to leave a job was highly correlated with the levels of abuse new RNs experienced. RNs who reported no verbal abuse were least likely to plan to leave in the next three years. Those who experienced moderate to high levels of abuse were most likely to leave in the next 12 months, but also indicated they planned to stay in nursing.

RNs working in Magnet hospitals were the least likely to report high levels of verbal abuse, as well as those working in ICUs.

Wendy Budin, RN-BC, PhD, FAAN, a study investigator and adjunct professor at the New York University College of Nursing, said in a news release, “Rather than yelling, swearing, insulting or humiliating behavior, most early career RNs report that the abuse they experienced involved condescension or lack of acknowledgement.”

This kind of subtle abuse is often overlooked and is less likely to be reported, which makes it all the more insidious and all the more important that hospital leadership confronts and prevents it.

The best way to retain nurses is to care for them. Having zero-tolerance for verbal abuse is a critical retention strategy.

To learn more about nurse retention, nurse recruitment, bringing self care to your facility and how to increase work life balance for nurses and healthcare professionals, go to SelfCare for HealthCare. CONTACT ME DIRECTLY to talk about customizing this powerful program for your employees.

Thank God and Veterans for Our Freedom!

Written by LeAnn Thieman, CSP, July 4th, 2013

Happy 4th of July!

Nurse Retention: Nurse Burnout Linked to High Frequency of Hospital-Acquired Infections

Written by LeAnn Thieman, CSP, July 2nd, 2013

Overburdened nurses are getting more attention from the media and administration, but one researcher always found a “missing link” in these stories.

“There’s so much data on nurse to patient ratios and hours worked but it simply being overworked doesn’t seem to tell the whole story,” said Jeannie Cimiotti, DNSc, RN, executive director of New Jersey Collaborating Center for Nursing and associate professor at Rutgers University School of Nursing. “What is it about nurse staffing that can promote infection?”

Cimiotti’s “burning question” about the connection between over-scheduled nurses and increasing infections led her to Christine Maslock’s theory of burnout and found the culprit.

“The burnout theory just fit,” she explained. “People in professions with constant contact with the public (firefighters, police offers, nurses) become burned out and cognitively detach. If a nurse suffers a high level of burnout and detaches, things start to go wrong. Maybe they don’t adhere to hand hygiene or the device stays in a little longer than it should.”

Sometimes the stress of the job causes the nurse to emotionally pull away from the environment and take the easy route.

Comparing catheter-associated urinary tract infection (CAUTI) rates with nurses’ patient loads (5.7 patients on average), Cimiotti and researchers from the University of Pennsylvania School of Nursing found that for each additional patient assigned to a nurse, there was roughly one additional infection per 1,000 patients (or 1,351 additional infections per year, calculated across the survey population).

Additionally, each 10% increase in a hospital’s high-burnout nurses corresponded with nearly one additional CAUTI and two additional SSIs per 1,000 patients annually (average rate of CAUTIs across hospitals was nine per 1,000 patients; for SSIs it was five per 1,000 patients).

To learn how reduce nurse burnout, improve patient care, strategies for nurse recruitment, nurse retention, bringing self care to your facility and how to increase work life balance for nurses and healthcare professionals, go to SelfCare for HealthCare. CONTACT ME DIRECTLY to talk about customizing this powerful program for your employees.